Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts

9/06/2012

The House of Hope and Fear: Life in a Big City Hospital Review

The House of Hope and Fear: Life in a Big City Hospital
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Dr. Young's new book is an engaging account of life at the large mission-driven county hospital in Seattle. I spent most of my 3rd year med school rotations there myself 12 years ago and am now working in a mission-driven community health center 18 miles away. My desire to serve the poor was a direct result of the dedication from the doctors and staff that I witnessed at Harborview. Now, I spend more than half my time educating and mentoring medical students and I plan on incorporating this book into our 2nd year curriculum.
The stories are diverse: some are about incredible patients and their challenging situations - socially, medically, psychologically; some are really more about the ethical dilemmas faced by providers, and faced by patient's families; other stories point out the inequities in healthcare, while demonstrating how this institution has creatively found a way to thrive financially while serving the least able to pay.
Most importantly to me - this book is hugely interesting, well written, easy to read, hard to put down and deserving of high praise. The reason this book is so good and the messages conveyed so well is that Dr. Young has incredible skill at portraying the humanity of her subjects. This is a book of true characters; unforgettable characters. The characters are patients, their loved ones and families, the infamous ER director, a remarkable specialist in nephrology, Dr. Young herself, and the staff of the hospital. I read their stories and can picture them on a gurney, in their offices, on the wards, in the ER; I can smell the smells again; and hear the sounds in the ICU.
This text can easily and effectively (each chapter is pretty well able to stand on its own as a separate reading - though together it reads as a cohesive story) be used regularly with medical students and public health and policy students - the examples in it are perfect for igniting debate about healthcare inequality, social justice, medical ethics, professional development, difficult patients, allocation of resources and care for the underserved.

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Opening with the view of an idealistic, young doctor entering her first post-graduate job at the local county hospital, The House of Hope and Fear explores not only the personal journey of one doctor's life and career, but also examines the health care system as a whole. The county hospital setting provides the author with a second education. With clear, eloquent text, she chronicles attempts made to treat those tossed aside by society along with the personal and ideological shifts that accompany this daunting task. All of the political aspects of the hospital's executive board are detailed in a gripping account of the hospital's inner workings, and a human face is expertly given to the healthcare crisis in America.

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8/28/2012

Partners in Health: How Physicians and Hospitals can be Accountable Together (J-B Public Health/Health Services Text) Review

Partners in Health: How Physicians and Hospitals can be Accountable Together (J-B Public Health/Health Services Text)
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A review of the need for collaboration between hospitals and doctors to improve quality and safety while increasing cost. Demonstrates how the reimbursement and legal environment create skewed and inappropriate incentives, but leaves out nursing and addresses outpatient medicine only superficially. As far as it goes, it is timely and practical. Its insights are useful for physicians in particular, especially physician managers. It does give an impression of some of the successful institutions, but the discussions are dry and technical but leave one wishing for more depth and detail. Storytelling would have strengthened the arguments.

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6/17/2012

Medical Tourism in Developing Countries Review

Medical Tourism in Developing Countries
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If you want to know Medical Tourism from an economist point of view and the implications for everyone in the health and tourism business, this is the book to get. The authors really did their work. The have a wealth of information for those who are involved in these industries. However, it is not the book to read if you are planning of becoming a medical tourist yourself. There are other books for that particular purpose.

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1/15/2012

State of the Heart: A Medical Tourist's True Story of Lifesaving Surgery in India Review

State of the Heart: A Medical Tourist's True Story of Lifesaving Surgery in India
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I borrowed the book "State of the Heart" from a friend and, at about the same time, I saw the movie "Sicko". What an experience, like a double whammy to our health care system in America. "State of the Heart" reflects many of the disturbing situations found in the movie. The book could be used as a guide to someone who might need to do the same thing, but it was like hearing someone tell a story of an incredible experience with major consequences. I enjoyed it so much I just bought my own copy of it tonight. It is so interesting to see how the same scenarios from the movie happened to two people who took a chance to get the medical help they needed and ended up being in the news. This book is timely and a great pleasure to read.

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10/25/2011

Chronic Crisis: Critical Care for America's Collapsing Healthcare System Review

Chronic Crisis: Critical Care for America's Collapsing Healthcare System
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The perfect book for what is on the agenda in the U.S. today. Selvoy M. Fillerup covers not only the health care system we have in the U.S. but compares it to the health care systems in several other industrialized countries. For example, Canada, Great Britain, Switzerland, Germany, etc. A collection of policies that work - and ones that don't work - are proposed and explained not only in the context of effective health care but in the context of why they make good economic sense. An effective health care system is not only accessable it must also be solvent which is to say sustainable. Ironically, with universal health care individual health care costs in the U.S. go down.
What might an effective national health care policy look like?
1) Everyone has a choice between private or public health care coverage. Offering both private and public options leverages the strength of both systems. Private systems are good at innovating, reducing costs and expanding infrastructure. Public systems implement the social contract that everyone in a civilized society has access to basic health care services.
2) Everyone is enrolled in either the public or private system. This can be default or mandatory enrollment default being preferred as there are no penalties - legal actions - involved if someone fails to enroll thus the system is simpler.
3) Community rating for coverage pricing. Individual risks are not evaluated thus, again, simplifying the system and reducing one of the biggest coverage administration costs - risk analysis. The need for risk analysis of individuals is greatly reduced when coverage is guaranteed.
4) Guaranteed issue. Coverage under the uniform benefits package cannot be denied for prior history or any other reason. When you walk into a public or private health insurance office and ask for the basic coverage package you cannot be denied.
5) A uniform benefits package that includes catastrophic care. Public and private care compete on the uniform benefits package based on price, reputation, convenience and other factors but not on what the uniform benefits package actually covers.
It has been said that the U.S. has the best health care in the world... and the worst way of paying for it. Policy needs to set the guidelines or "playing field" in which the health care free market operates. With an effective policy - as outlined above - the free market can be an effective mechanism for health care delivery.

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The United States healthcare system leaks lives and dollars like a sieve. It neglects the needy and the poor. It is immoral. It is expensive. It is inefficient. It is, quite simply, broken. Dr. Selvoy Fillerup is an expert on international healthcare policy. As such, he has a uniquely informed perspective on why healthcare systems of other countries work, and why the US healthcare system does not. Chronic Crisis is straightforward, accessible, and direct to the point about one of the hottest political topics of our time. Explicitly nonpartisan, Dr. Fillerup offers a fresh look and reasonable solutions for this growing domestic crisis. Concerned Americans cannot afford to neglect this book!

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8/20/2011

Strong Medicine: What's Wrong with America's Health Care System and How We Can Fix It Review

Strong Medicine: What's Wrong with America's Health Care System and How We Can Fix It
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While this may be considered a primer for those familiar with healthcare administration, insurers, and payors of healthcare today, it offers insights for consumers of healthcare that put the issues in context. A great summary of the need for accountability, and for reward for positive behavior in delivering healthcare and appropriate use of healthcare resources

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